DEAR DR. ROACH: A friend is not getting vaccinated for COVID-19 because she thinks the vaccines could cause permanent fertility issues. Would you please comment on this? — M.S.

ANSWER: I can understand why a woman would be concerned about losing fertility. However, this is just not a concern that is borne out by the science. One theoretical concern has been that exposure to the spike protein in the coronavirus (SARS-CoV-2) or to the same spike protein that the vaccine causes muscle cells to make could cause the body to make antibodies against a protein called syncytin-1 in the placenta if the two proteins were similar enough.

Fortunately, some of the best medical experts in the field have looked carefully at this and found so little similarity that there is no reason for concern. More importantly, the studies we have from people who had COVID-19 and who were exposed to huge amounts of spike protein (far more than people who get the vaccine are exposed to) have shown no reduction in fertility nor any increase loss of pregnancies.

Dr. Keith Roach

There have been many vaccines, including polio and human papillomavirus, that have led to concerns about fertility, but long experience with these other vaccines has shown that fertility is not adversely affected. The data so far with the COVID-19 vaccines shows no evidence that fertility could be reduced by the vaccines. During the Pfizer vaccine tests, for example, 23 women volunteers in the study became pregnant, and the only one who suffered a pregnancy loss had not received the actual vaccine, but a placebo.

The best evidence continues to support COVID-19 vaccines, and the myth of vaccine-related infertility can be dismissed.

DEAR DR. ROACH: Because of an enlarged prostate, my guy wasn’t getting much sleep at night. So, he had the best urologist in town do the TURP procedure in hopes of resolving the problem. He was prescribed Flomax, which he takes every day.

Now, a year later, he still has the urination urge at least three times a night. Many nights it’s five times! Please help — he needs some sleep. Thank you! — Anon.

ANSWER: I’d like to help your guy, but 15% to 30% of men continue to have symptoms, and unfortunately some people do get worse after a surgical procedure, like a transurethral resection of the prostate. In that case, medication treatment usually is best. There are at least three forms of therapy to consider, in addition to the standard therapy of an alpha blocker, such as tamsulosin (Flomax).

One is treatment to reduce dihydrotestosterone, such as finasteride. This treatment is slow to take effect, and only works when residual prostate tissue is causing the symptoms.

The second is a simple anti-inflammatory, specifically ibuprofen. Many men have written me with surprise at how effective this is, with just a low dose at bedtime.

Finally, sometimes what seems like prostate problems can actually be bladder problems, and treatment for an overactive bladder can help symptoms.

Only if medication treatment has failed after a really good try would I consider referral for a repeat procedure.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.

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